MassHealth Income Limits in Massachusetts (2026)

MassHealth covers approximately 2.1 million Massachusetts residents in 2026, roughly 30% of the state's population, making it one of the largest Medicaid programs relative to state population in the nation. Massachusetts was already extending Medicaid-like coverage to low-income adults before the ACA: the 2006 Massachusetts Health Care Reform Act (Chapter 58 of the Acts of 2006, commonly called RomneyCare) extended coverage to individuals up to 133% of the Federal Poverty Level through Commonwealth Care. When the ACA Medicaid expansion took effect on January 1, 2014, MassHealth absorbed those enrollees and added more, covering adults up to 138% FPL. The 2026 Federal Poverty Level base is $15,960 for a single person in the 48 contiguous states, with a $5,680 increment per additional household member, and those figures anchor every MassHealth income threshold shown in this guide.

MassHealth eligibility divides into three main MAGI-based groups and one asset-tested group. Non-pregnant adults ages 19 to 64 qualify under MassHealth CarePlus (the ACA expansion group) at up to 138% FPL. Pregnant women qualify under MassHealth Standard for Pregnant Women at up to 200% FPL, with coverage extending 60 days postpartum (federal law requires 12 months of postpartum coverage, and Massachusetts was an early adopter of the 12-month extension). Children up to age 18 qualify under MassHealth Standard at up to 150% FPL, with MassHealth Family Assistance (CHIP-funded) bridging coverage for children and young adults up to 300% FPL at low premiums. The fourth category, aged, blind, and disabled (ABD) adults, qualifies under MassHealth Standard at income levels tied to SSI: approximately $1,071 per month for an individual in 2026, with a $2,000 individual asset limit. Unlike MAGI categories, the ABD category carries an asset test.

The household-size table below shows the 2026 MassHealth income limits across the three major MAGI populations. One notable feature of MassHealth is its estate recovery program: Massachusetts is among the states that aggressively pursues estate recovery for Medicaid costs paid for members age 55 and older, including for services beyond long-term care. Individuals who receive MassHealth Standard (aged, blind, or disabled) and who own a home should consult a Massachusetts elder law attorney before enrolling, as the estate recovery rules can affect heirs. For most working-age adults applying for MassHealth CarePlus, estate recovery does not apply. Massachusetts also has a state-level individual mandate: most residents who can afford health insurance must maintain minimum creditable coverage or pay a penalty on their state income tax return, making MassHealth enrollment critical for those who qualify.

MassHealth (Massachusetts Medicaid) income limits by household size (2026)

The 2026 MassHealth income guidelines below are based on the 2026 Federal Poverty Level for the 48 contiguous states. Adult column = MassHealth CarePlus expansion group (138% FPL, covers adults ages 19 to 64 with or without dependent children). Children column = MassHealth Standard for children (150% FPL for ages 0 to 18; MassHealth Family Assistance CHIP coverage extends to 300% FPL with small premiums). Pregnancy column = MassHealth Standard for Pregnant Women (200% FPL), with 12 months of postpartum coverage. Add roughly $5,680 of annual income per additional household member.

MassHealth (Massachusetts Medicaid) eligibility requirements (non-income)

MassHealth eligibility in 2026 covers five non-income criteria that every applicant must meet in addition to the income thresholds in the table above. Income is the primary gate, but residency, citizenship or immigration status, age, and Social Security Number requirements all apply and are verified during the application process.

• Massachusetts residency. MassHealth applicants must live in Massachusetts with the intent to remain. Residency is established through a current Massachusetts address verified by a utility bill, lease, mortgage statement, or government-issued document with the applicant's name and address. Individuals temporarily away from the state (students, seasonal workers) may still qualify if Massachusetts remains their primary home state.
• U.S. citizenship or qualifying immigration status. MassHealth Standard and CarePlus require U.S. citizenship, U.S. national status, or a qualifying immigration status (lawful permanent resident, refugee, asylee, or certain other lawfully present immigrants). Newly arrived lawful permanent residents are subject to a 5-year bar on federal Medicaid funding, but Massachusetts uses state funds to cover lawful permanent residents during their first 5 years. Undocumented immigrants do not qualify for full MassHealth, but they may qualify for MassHealth Limited (emergency-only services) or limited prenatal care.
• Social Security Number. MassHealth requires a valid Social Security Number (SSN) for all applicants who have one or are eligible to obtain one. Applicants who do not have an SSN because of their immigration status may still apply, and MassHealth will help facilitate the SSN application process in some cases. Children who are U.S. citizens may apply even if a parent cannot provide an SSN.
• Age requirements by program. MassHealth CarePlus (the ACA expansion group) covers adults ages 19 to 64. MassHealth Standard covers children from birth through age 18, pregnant women of any age, and adults age 65 and older (aged, blind, or disabled category). Young adults ages 19 to 26 who aged out of MassHealth as children may qualify under CarePlus if their income is at or below 138% FPL. Adults age 65 and older transition to MassHealth Standard (the ABD category), which coordinates with Medicare for dual-eligible members.
• Asset test (ABD category only). For MAGI-based categories (CarePlus adults, pregnant women, children), there is no asset test. For the aged, blind, and disabled (ABD) category under MassHealth Standard, Massachusetts applies a $2,000 individual asset limit and $3,000 couple limit. Exempt assets include the primary home (if the applicant or spouse lives there), one vehicle, personal property, and certain burial arrangements. Massachusetts operates an aggressive estate recovery program for members age 55 and older who receive long-term services and supports, meaning the estate of a qualifying member may be subject to a claim after death.
• Other health insurance. MassHealth applies cost avoidance and third-party liability rules: if an applicant has access to employer-sponsored insurance or another group health plan, MassHealth evaluates whether enrolling in that coverage is cost-effective (less expensive for MassHealth than paying full claims). If employer coverage is deemed cost-effective, MassHealth may require the member to enroll in it and will pay the employee premium share instead of covering claims directly. Massachusetts law does not disqualify members who have Medicare from receiving MassHealth, and dual-eligible members receive comprehensive coordination of benefits.

What income counts for MassHealth (Massachusetts Medicaid)

MassHealth uses the federal Modified Adjusted Gross Income (MAGI) methodology for all non-ABD Medicaid categories, including CarePlus adults, pregnant women, and children. MAGI for MassHealth purposes mirrors the IRS MAGI definition with a few Medicaid-specific adjustments. Massachusetts also applies the standard federal 5% income disregard to the top of the threshold, which effectively raises the posted income limit by 5 percentage points. This means MassHealth CarePlus adults are in practice covered at approximately 143% FPL rather than exactly 138% FPL, though the posted eligibility threshold is still stated as 138% FPL. For the aged, blind, and disabled (ABD) category, MassHealth uses a different income methodology tied to SSI rules, not MAGI.

Income sources included

• Wages, salaries, and tips (W-2 income), including overtime and bonuses received during the calendar year.
• Net self-employment earnings (gross business income minus allowable business expenses). 1099 contractors and sole proprietors report net earnings after deducting ordinary and necessary business costs.
• Interest income, dividend income, and capital gains distributions from investments, savings accounts, and brokerage accounts.
• Unemployment insurance benefits received during the benefit year.
• Social Security Disability Insurance (SSDI) benefits and Social Security retirement or survivor benefits (the taxable portion counts; the non-taxable portion under the IRS provisional income formula may be excluded).
• Pension and retirement distributions, including traditional IRA and 401(k) withdrawals, to the extent they are included in federal adjusted gross income.
• Alimony received under a divorce or separation agreement executed before January 1, 2019. Alimony from agreements executed on or after January 1, 2019 is not taxable income under federal law (TCJA change) and therefore does not count as MAGI for MassHealth.
• Rental income and royalty income (net of allowable deductions for depreciation, maintenance, and mortgage interest).

Income sources excluded

• Supplemental Security Income (SSI) payments. SSI is not taxable income and is explicitly excluded from the MAGI income calculation for Medicaid. Do not confuse SSI with SSDI: SSDI counts; SSI does not.
• Child support received. Child support payments received by a custodial parent are not counted as income for MassHealth MAGI purposes.
• Veterans' benefits, including VA disability compensation, pension payments, and GI Bill education benefits. These are not included in federal adjusted gross income and therefore not counted as MAGI.
• Workers' compensation payments for work-related injuries or illnesses.
• Gifts, inheritances, and one-time lump-sum amounts (life insurance proceeds, legal settlements). These are not included in MAGI unless they generate income (for example, invested inheritance that earns dividends or interest counts as income in the year earned).
• TANF (Temporary Assistance for Needy Families) cash assistance payments from the Massachusetts Department of Transitional Assistance (DTA).

How to apply for MassHealth (Massachusetts Medicaid) in Massachusetts

MassHealth applications in 2026 go through the Massachusetts Health Connector or the MassHealth Enrollment Centers operated by the Executive Office of Health and Human Services (EOHHS). Massachusetts integrated its ACA marketplace and Medicaid intake through a single portal at mahealthconnector.org. Applicants can apply online, by phone at 1-800-841-2900 (MassHealth Customer Service), by mail, or in person at a MassHealth Enrollment Center. The same application is used for MassHealth CarePlus (Medicaid for adults), MassHealth Standard (children, pregnant women, ABD), MassHealth Family Assistance (CHIP), and ConnectorCare (subsidized marketplace plans for adults 138-300% FPL). Applying online is the fastest route: the system does real-time eligibility screening and can often confirm MassHealth enrollment on the same day.

1. 1. Gather your documents before you start. You will need proof of Massachusetts residency, a Social Security Number (or documentation of your immigration status), proof of U.S. citizenship or qualifying immigration status, and income documentation for all household members. Have your most recent pay stubs, tax returns, and any benefit award letters ready.
2. 2. Go to mahealthconnector.org and click 'Apply Now'. Create an account or log in to an existing account. The online application takes approximately 20 to 45 minutes to complete for a standard household. The system will ask about all household members, their incomes, and their current health coverage.
3. 3. Complete and submit the application. List every household member applying for coverage. Report all income sources accurately. Upload or mail supporting documents. Sign the application electronically. MassHealth will issue a confirmation notice with a case number; keep that number for reference.
4. 4. Respond to any requests for additional information. MassHealth may send a Request for Information (RFI) notice asking for documentation it could not verify electronically. You must respond within the time specified in the notice (typically 10 days). Missing the deadline is one of the most common reasons applications are delayed or denied.
5. 5. Receive your eligibility determination. MassHealth issues a written notice of the eligibility decision. If approved, MassHealth will issue a member ID card and enroll you in a managed care plan (if applicable). Coverage is generally retroactive to the date of application. If you are approved for MassHealth Standard as a pregnant woman, coverage is retroactive to the first day of the month you applied.
6. 6. Choose a MassHealth managed care plan if prompted. Most MassHealth CarePlus and Standard members are enrolled in a Managed Care Organization (MCO). Massachusetts contracts with several MCOs including BMC HealthNet Plan, Boston Children's ACO, Fallon Health, Tufts Health Together, and UnitedHealthcare Community Plan. If you do not choose a plan within the selection window, MassHealth auto-assigns you to one. You can switch plans once per year or when you have good cause.

Official portal: mahealthconnector.org

Documents needed

• Photo ID for the head of household (Massachusetts driver's license, state-issued ID, passport, or other government-issued photo ID).
• Social Security Numbers for every household member applying for MassHealth coverage (or documentation of immigration status if no SSN is available).
• Proof of Massachusetts residency: a current utility bill, lease agreement, mortgage statement, or official mail addressed to you at your Massachusetts address.
• Proof of U.S. citizenship or qualifying immigration status: U.S. birth certificate, U.S. passport, Certificate of Naturalization, Permanent Resident Card (green card), Employment Authorization Document, or other USCIS documentation.
• Income documentation: last 30 days of pay stubs (or most recent W-2), self-employment income and expense records for the past 12 months (for 1099 earners), Social Security or SSDI award letters, pension or retirement income statements, and any other income documentation for all household members.
• Most recent federal tax return (Form 1040) if available. MassHealth may use the tax return to verify household composition and income. If you did not file a tax return, a signed statement explaining why may be requested.

Processing timeline: Standard MassHealth applications are processed within 45 days of receiving a completed application. Pregnancy applications are processed within 15 days under federal expedited-processing rules. Applications for the aged, blind, or disabled (ABD) category can take up to 90 days because they require a medical or disability determination. Online applications through mahealthconnector.org that can be verified through electronic data sources (tax records, SSA records, state wage data) may receive same-day or next-day determinations in many cases.

Common reasons applications get denied

• Income exceeds the applicable MassHealth threshold for the applicant's population group. This is the most common reason for denial. Adults earning above 138% FPL ($22,025 for a single person in 2026) do not qualify for MassHealth CarePlus but may qualify for ConnectorCare (138-300% FPL) or ACA marketplace premium tax credits (100-400% FPL).
• Failure to respond to a Request for Information (RFI) within the specified deadline. MassHealth sends RFIs by mail when it cannot electronically verify information. Missing the response deadline (typically 10 days) results in denial or closure of the application.
• Massachusetts residency not established. Applicants who cannot provide a valid Massachusetts address with supporting documentation (utility bill, lease, or similar) will be denied pending proof of residency.
• Immigration status does not qualify for MassHealth Standard or CarePlus federal funding. Undocumented immigrants may receive MassHealth Limited (emergency services only). Newly arrived lawful permanent residents may receive state-funded MassHealth during the 5-year federal bar period.
• Assets above the limit for the ABD category. For aged, blind, and disabled applicants under MassHealth Standard, a countable asset total above $2,000 (individual) or $3,000 (couple) results in denial until assets are spent down to the limit. MAGI-based categories (CarePlus, children, pregnant women) have no asset test and are not subject to this denial reason.

If your child's family income is above the MassHealth Standard limit

MassHealth Standard covers children up to 150% of the Federal Poverty Level ($49,500 for a family of four in 2026). Children in households earning between 150% FPL and 300% FPL may qualify for MassHealth Family Assistance, Massachusetts's CHIP-funded program. MassHealth Family Assistance covers children under age 19 and young adults under age 21 in certain cases. Unlike MassHealth Standard, Family Assistance charges sliding-scale monthly premiums (typically $20 to $50 per child per month at the upper income range) but provides comprehensive health coverage. Children above 300% FPL can apply for coverage through the Massachusetts Health Connector marketplace. Use the income table on this page to see whether MassHealth Standard covers your child first, then check MassHealth Family Assistance if your family income is higher.

Compare MassHealth and CHIP income limits across all 50 states

If you are 65 or older with limited income: Medicare Savings Programs through MassHealth

Massachusetts runs four Medicare Savings Programs (MSPs) through MassHealth that help low-income Medicare beneficiaries pay their Medicare premiums, deductibles, and cost-sharing. The four tiers are: Qualified Medicare Beneficiary (QMB) for individuals at or below 100% FPL ($15,960/year in 2026), which pays Part A and Part B premiums plus deductibles and coinsurance; Specified Low-Income Medicare Beneficiary (SLMB) for individuals at 100-120% FPL, which pays the Part B premium only; Qualifying Individual (QI) for individuals at 120-135% FPL, which also pays the Part B premium only; and Qualified Disabled and Working Individuals (QDWI) for working disabled individuals who lost Medicare due to returning to work, up to 200% FPL. Massachusetts also provides full MassHealth Standard benefits to many dual-eligible members (those with both Medicare and MassHealth), covering services Medicare does not pay such as dental, vision, long-term care, and behavioral health. Dual-eligible members in Massachusetts are automatically enrolled in a One Care or Senior Care Options plan where available, which integrates MassHealth and Medicare services. Apply for an MSP by contacting MassHealth at 1-800-841-2900 or applying online at mahealthconnector.org.

Read the Medicare eligibility guide

Frequently Asked Questions